When Suniti Solomon (the physician who documented the first cases of Human Immunodeficiency Virus (HIV) infection in India in 1986) passed away on July 28, 2015, The New Yorker stated this:
“As HIV swept across the world, in the mid-nineteen-eighties, no country possessed a more menacing mix of conditions, predilections, and the kind of poverty likely to hasten an AIDS epidemic than India… Many researchers predicted a crisis unlike those in any other nation. But it never happened — in part because India had Suniti Solomon, the AIDS-treatment pioneer who died on Tuesday, at the age of seventy-six. In 1986, Solomon, a microbiologist then teaching at Madras Medical College, diagnosed the country’s first cases.”
That begs the question: how would the AIDS epidemic in India have shaped up had Suniti Solomon not chosen to become a medical microbiologist? It certainly was not her first choice of specialty. I know this; she was my aunt.
From a young age, she displayed the sort of pluck that she would be known for in the last three decades of her life when she fought both HIV infection and the stigma which accompanied it; she considered the latter to be just as, if not more, dangerous than the virus. Such courage was also part of her personal life: this lady from a Marathi-speaking Hindu family married a Tamil Christian, Solomon Victor, at a time when inter-religious and inter-community marriages were as taboo as taboo could be in India, much as interracial marriages then were in the United States.
In 1967, Solomon Victor (who would later become one of India’s premier cardiothoracic surgeons) was awarded a British Commonwealth scholarship for training in cardiac surgery under the renowned surgeon Donald Ross at the National Heart Hospital, London. Suniti obtained an appointment as a junior physician in general medicine at King’s College Hospital. They had prolonged stints when one was on night duty while the other worked the day shift. Before one returned, the other had eaten breakfast and left. For days on end, they communicated by leaving notes for each other on the kitchen countertop.
Solomon Victor finally decided that enough was enough, and asked Suniti to choose a non-clinical specialty for her postgraduate degree. The decision was tough — the age-old ‘career versus family’ dilemma. She preferred general medicine. But family life was important too. And she wasn’t giving up medicine, only her choice of specialty. Nobody, she least of all, could have anticipated how her decision that day would have a crucial impact two decades later when India was confronted by the greatest health crisis of the era. In chill and bleak London, they were just a struggling young couple trying to piece their life together. When they moved on to the United States to further their medical training, Suniti became a medical resident in pathology in Chicago’s Cook County Hospital.
She couldn’t complete her residency. In 1971, Solomon Victor’s mentor Dr. C. Sadasivam, founder of the cardiothoracic surgery department at the Government General Hospital, Chennai, died unexpectedly. Solomon Victor had to return to stabilise the fledgling department, and Suniti opted for a postgraduate course at Madras Medical College. The logical choice was pathology, building on her Chicago residency experience, but among the non-clinical specialties, pathology was the most competitive. She ended choosing microbiology because it included the sub-specialty of immunology, which she believed would become increasingly important in our battles against infectious diseases.
After her MD, she joined the faculty of the Institute of Microbiology in Madras Medical College. It was here, in the early 1980s, that she was certain that HIV infection was present and spreading in India although the government kept ducking the issue. Reading papers published in various international medical journals convinced her that despite the politicians’ assertions of the protective superiority of Indian culture over that of the decadent West, human nature prevailed the world over. So she initiated a research project to ferret out the virus. Her efforts included asking a postgraduate student to take up the topic as a research thesis.
The blood samples Suniti and her team collected included 100 from prostitutes of a remand home. Of these 100, six tested positive for HIV. Suniti sent the samples to also be independently tested at Johns Hopkins University, Baltimore, USA. Hopkins reconfirmed her findings. Six out of 100 was bad news, given the size of India’s population. HIV had launched India on a trajectory that would topple it from the cliff onto the rocks below if nothing was done.
A challenge of such proportions would make any starting point seem puny. But a beginning was necessary, so Suniti set up India’s first HIV voluntary counselling and testing centre at Madras Medical College, the prototype of what she would later develop in her non-governmental organisation named after her father, the Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE). The government was cocooned in too much red tape; she needed the freedom of her own NGO.
My father helped my aunt with seed money but an organisation can only go so far with limited funds. Anyone else would have squatted on their haunches trying to raise additional capital before proceeding further, but Suniti adapted again with this offbeat philosophy: Do what you love, what your heart and your gut tells you is right, and the money will find its way to you. She started with education. The older generation was mired in its stuck-in-the-mud mindset. The young were more open, more ready to listen and objectively evaluate what they heard. She started the first HIV awareness programmes in schools and colleges (with sex education as an integral component) braving the backlash from a conservative society. In time (it was not quick, but her confidence never flagged through the years of struggle), she earned national and international recognition for her pioneering work, and along with it, the funding.
Her growing reputation as “the AIDS doctor of Chennai” led people to her for HIV testing and counselling. She set up her office on the upper storey of a house on a residential street in T.Nagar, so people could casually walk in without attracting attention of passers-by. Those who tested HIV-positive needed drugs, so she started a pharmacy. Seriously ill patients refused admission by (or blatantly mistreated at) the public hospitals needed a place to recuperate under treatment, so she ran an in-patient service at the Voluntary Health Services (VHS) campus in Taramani. Thus the old love — general medicine — that she had parted with decades ago in London returned to her, at least for awhile, until she found and trained junior doctors who could take over the daily care of patients.
YRG CARE, then, grew into what it is today because of Dr. Suniti’s adaptability to the situations that confronted her. But this doesn’t imply that she meekly adjusted every time something came up. When principles were at stake, she stood firm, whether it meant not caving in to political bullying, or taking up an issue on behalf of a patient against powerful and antagonistic authorities. It was a combination of the two that made her what and who she was, and countless others have been the better off for it.
